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SESSION 5THE ROLE OF GOVERNANCE INIMPROVING ACCESS TO HEALTHSERVICES FOR THE MOSTMARGINALIZED IN SOCIETY

Moderator: Bob Fryatt, Director,HFG Project

Prince Mahidol Award Conference

USAID Side Meeting

Bangkok

January 29, 2017

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OVERVIEW

Jodi Charles, Senior HealthSystems Advisor, Office for HealthSystems, USAID

Marshalling the Evidence for HealthGovernance

To address to this evidence gap, USAID’s Office ofHealth Systems, through the Health Finance andGovernance Project (HFG), and WHO launchedMarshalling the Evidence for Health Governancein September 2016.

Overall Goal

• To increase awareness and understanding of the fieldof evidence on governance, how it contributes tohealth system performance, and how the field ofhealth governance is evolving at the country level.

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Marshalling the Evidence for Governance:Contributions to Health System Performance and

Health Outcomes

Marshalling the Evidence for Governance:Contributions to Health System Performance and

Health Outcomes

Jodi Charles, Senior Health System Advisor

USAID Office of Health Systems

Jodi Charles, Senior Health System Advisor

USAID Office of Health Systems

• USAID’sVision for Health SystemsStrengthening outlines keypriorities to help guide investmentin a way that is evidence-based, andcontributes to positive healthoutcomes.

• Health Governance:

• ImprovingAccountability/Transparency

• Building strongerpolicy/regulatoryenvironments

• Civil society/private sectorengagement

• Engaging new generation ofHSS leaders

USAID Approach to HealthSystems Strengthening

• MtE came in response toincreasing demand forevidence:

– Identify high impactinterventions in HSS

– Program scarce fundsin an environment ofcompeting priorities

– Respond to increasingdemand todemonstrate results inhealth

Marshalling the Evidence(MtE) for Health Systems

Governance: State of the Evidence

• Increasing emphasis on improving the accountabilityand transparency of health systems, strengtheningcountry policies and institutions as they move towardUHC

• A recognized evidence gap in health governance thatresults in avoidance of health governance efforts or areliance on a limited set of governance interventions

• There is need for rigor and more standardizedapproaches for health governance interventions

HealthGovernance

Patient rights/empowerment

Policy &Regulation

Information &Intelligence

HealthOutcomes

Broad Governance

Democratization

War/Conflict

Corruption

Public Financialmanagement

Decentralization

Accountability

HealthServices

MtE Framework: Multiple channels through whichgovernance may affect health – both direct and indirect

Source: Sara Bennett, HFG Project

HealthGovernance

Patient rights/empowerment

Policy &Regulation

Information &Intelligence

HealthOutcom

es

Broad Governance

Democratization

War/Conflict

Corruption

Public Financialmanagement

Decentralization

Accountability

HealthService

s

September launch event: 26 governance expertsfrom 8 organizations select four themes

Thematic Working Groups

Four TWGs were formed to consolidate evidenceby conducting literature reviews and key informantinterviews from low and middle income countries inthese areas:

Public Financial Management (PFM)

Policy and Regulation

The Use of Knowledge in Health Systems

Accountability

Thematic Working Groups (cont.)

• Members of the TWGs are from diverse organizations andacademic institutions

• The TWGs are responsible for consolidating evidence fromlow and middle income countries and presenting their findingat an upcoming event.

• Each TWG has two co-chairs who are responsible for guidingthe group to organize and package the research and fieldpractice on their themes

Expected Results

• Reports synthesizing the evidence on how governanceinterventions in the thematic areas improve health systemperformance and health outcomes.

• Specific examples of what some LMICs are doing in healthgovernance that is contributing to improving their healthsystems and health outcomes

• A list of health governance priority areas where further actionsor evidence would be most useful

– linking to ongoing efforts to strengthen the evidence base

• Contribute to global agenda for health governance for UHC

Marshalling the Evidence Event in Fall 2017

• In Fall 2017, USAID and WHO will host a high levelevent over two days in Washington DC

• The event will serve as a platform to present:

–The findings of the literature

–Review the results

– Introduce new approaches and tools

–Foster dialogue between development partners,researchers, health governance practitioners, andpolicy makers.

Timeline of Tasks and Deliverables

Definition ofterms and

scope of thethematic areas

Nov. 2016

LiteratureReviews

Dec. 2016

Undertake KeyInformantInterviews

Spring 2017

Write up ofTWG Reports

Summer 2017

Prepare TWGPresentations

Summer 2017

Main Event

Fall 2017

Thank you